摘要
目的比较绝经后妇女(观察组)和正常育龄期妇女(对照组)的骨代谢相关指标,及瘦素、白细胞介素6(IL-6)的水平变化,探索骨质疏松症发病可能的相关因素;观察口服阿仑膦酸钠肠溶片在预防和治疗骨质疏松症方面的有效性和安全性。方法对照组25例不加任何处理。观察组42例受试者给予以口服钙尔奇D 600mg/d以及阿仑膦酸钠肠溶片70mg,每周1次,连续服用6个月。分别测定观察组和对照组骨密度指标及瘦素、IL-6水平,以及观察组服药前、服药6个月末和停药1年后腰椎2～4(L2～4)、左侧股骨颈、Ward三角区、股骨粗隆的骨密度,以及血碱性磷酸酶(ALP),血清骨钙素(BGP),抗酒石酸酸性磷酸酶(TRAP),肝、肾功能,血清钙(Ca)、磷(P)等生化指标,综合评价口服阿仑膦酸钠肠溶片的临床疗效、安全性和耐受性。结果与对照组比较,观察组L2～4及左股骨颈、股骨粗隆和Ward三角区的骨密度显著减少(P<0.01);观察组血清IL-6水平高于对照组,(69.22±7.01)μg/L vs(11.37±4.86)μg/L(P<0.01)。应用阿仑膦酸钠肠溶片治疗6个月末,观察组L2～4以及左股骨颈、股骨粗隆和Ward三角区的骨密度与治疗前比较显著增加,治疗前、治疗后和停药1年L2～4(0.83±0.08)g/m3、(0.88±0.08)g/m3和(0.87±0.07)g/m3(P<0.05);股骨颈(0.68±0.11)g/m3、(0.72±0.07)g/m3和(0.73±0.06)g/m3(P<0.05);骨股粗隆(0.61±0.09)g/m3、(0.71±0.09)g/m3和(0.69±0.08)g/m3(P<0.01);Ward三角区(0.48±0.13)g/m3、(0.57±0.11)g/m3和(0.55±0.13)g/m3(P<0.01)。ALP、BGP、TRAP水平较治疗前显著降低(P<0.05或<0.01)。结论观察组骨质疏松症的发生与绝经后骨代谢加快相关,与体脂含量及瘦素水平无明显相关。口服阿仑膦酸钠肠溶片可显著增加绝经后骨质疏松妇女的骨密度,降低骨转化指标,且无明显不良反应。
Objective The indicators which related with bone metabolism and the content level of leptin and Interleukin-6（IL-6） were compared between postmenopausal women（observed group） and normal child-bearing age women（control group） to explore the incidence possibility of osteoporosis;To observe and analyze the efficacy and safety of alendronate sodium enteric-coated tablets in prevention and treatment of osteoporosis in postmenopausal women. Methods The subjects in control group（25 cases） got no treatment,while all postmenopausal women in observed group（42 cases） took Caltrate D 600 mg/d and alendronate sodium enteric-coated tablets 70 mg per week orally in 6 months.Bone mineral density（BMD） and leptin,interleukin-6 level of observed group and control group,BMD of lumbar vertebrae 2-4（L2-4）,left neck of femur,Ward triangle,femoral trochanter,and alkaline phosphatase（ALP）,bone gla protein（BGP）,tartrate-resistant acid phosphatase（TRAP）,calcium（Ca）,phosphate（P） before the treatment,in the end of the 6th month and 1 year after the treatment were measured.The relevant indicators of bone metabolism of two groups were compared. Results Compared with control group,the BMD of L2-4 and left femoral neck,femoral trochanter and Ward triangle in observed group reduced significantly（P0.01）.Serum interleukin-6 in observed group was significantly higher than that of control group,（69.22±7.01） μg/L vs（11.37±4.86） μg/L（P0.01）.At the end of the 6th month of the treatment,the BMD of observed group L2-4,left femoral neck,femoral trochanter and Ward triangle increased significantly as compared with that before the treatment（P0.05 or 0.01）.L2-4（0.83±0.08） g/m3,（0.88±0.08） g/m3 vs（0.87±0.07） g/m3（P0.05）;left femoral neck（0.68±0.11） g/m3,（0.72±0.07） g/m3 vs（0.73±0.06） g/m3（P0.05）;Bone strands of thick long（0.61±0.09） g/m3,（0.71±0.09） g/m3 vs（0.69±0.08） g/m3（P0.01）;Ward triangle（0.48±0.13） g/m3,（0.57±0.11） g/m3 and（0.55±0.13） g/m3（P0.01）.ALP,BGP,TRAP level reduced significantly compared with those before treatment（P0.05 or 0.01）.ALP,BGP,TRAP level reduced significantly as compared with those before the treatment（P0.05 or 0.01）. Conclusion Osteoporosis in observed group is related to the speed up of bone metabolism.Alendronate sodium enteric-coated tablets for treating postmenopausal osteoporosis can significantly increase BMD,degrade the bone transformational index,and the drug has few side effects.
出处
《临床荟萃》
CAS
2012年第5期386-389,共4页
Clinical Focus
